March 2018 CPN

CPN

Community Pharmacy News – March 2018

Pharmacy proves its quality

New figures show that over 90% of community pharmacies took part in Quality Payments Scheme Pharmacy campaign goes digital | GDPR update | Changes to proof of exemption

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

2017/18 Quality Payments declaration data published The final declaration data for Quality Payments reveals that 11,410 community pharmacies took part in the scheme.

The NHS Business Services Authority (NHS BSA) has published the declaration data for the November 2017 review point, as well as the combined data from the April and November 2017 declarations of the Quality Payment Scheme 2017/18.

The data provides a breakdown of the number of community pharmacy contractors who declared that they met the Gateway criteria and the number of contractors who declared they met the individual Quality criteria.

To accompany this data, NHS England has published infographics which summarise the November data and the overall achievement figures for the scheme in 2017/18.

View the report and declaration data and infographics in full at: ow.ly/5pSJ30iUVqQ Commenting on the publication of the data, Alastair Buxton, Director of NHS Services at PSNC, said: “Congratulations to pharmacy teams and

LPCs on the phenomenal engagement with the Quality Payments Scheme as reflected by the declaration data over the two review periods. We are delighted to see such high levels of participation; the data published today is a testament to their hard work and commitment to continuously improving the quality of the services they provide to patients and the public. Particularly commendable are the 7,981 contractors who achieved the maximum points for each quality criteria across both review points.

PSNC is very grateful to the LPCs who worked tirelessly to support their contractors to successfully engage with and implement the Quality Payments Scheme.

PSNC has recently had discussions with the Department of Health and Social Care and NHS England about transitional arrangements for 2018/19, including the Quality Payments Scheme, and an announcement is expected shortly. PSNC will inform contractors about the transitional arrangements as soon possible.”

Infographic produced by NHS England

Community pharmacy can do more to help reduce admissions

The National Audit Office (NAO) has published a report warning that the impact on hospitals of rising emergency admissions poses ‘a serious challenge’ to the service and to the financial position of the NHS. The NHS had done well to reduce the impact, but it said there were still too many avoidable admissions and too much unexplained variation.

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The NAO set out a series of recommendations including that: • The Department, NHS England and NHS Improvement should establish an evidence base for what works in reducing emergency admissions and use this to inform future national programmes; • NHS England and NHS Improvement should determine and accelerate the dissemination of the learnings from the new care models; • NHS England and NHS Digital should link hospital activity data with primary, community health care and social care data; and • The Department, NHS England and NHS Improvement should develop a data

led understanding of what causes local variations and set out how and by when they will reduce those variations.

Alastair Buxton, Director of NHS Services at PSNC, said: “Managing emergency hospital admissions is a big issue for the health service and we are not surprised by the NAO’s conclusion.

As the NHS seeks to reduce emergency hospital admissions while grappling with its financial and capacity issues, it simply cannot afford to overlook the very great contribution that community pharmacies could make to these efforts.”

Read the National Audit Office report at: ow.ly/bnvH30iPCTg

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

Stay Well Pharmacy: Campaign update Digital resources, including mini videos for sharing on social media, have been made available to help maintain the momentum of the campaign.

NHS England has begun a second wave of promotion for the Stay Well Pharmacy campaign, encouraging all community pharmacy teams to make use of new social media materials.

The Stay Well Pharmacy campaign, which launched last month, is an NHS England campaign which aims to increase the public’s trust and confidence in community pharmacy teams as the place to go for clinical advice for minor health concerns, and encourages people to use pharmacies rather than visiting their GP as a first port of call.

With campaign toolkits now delivered to 12,000 pharmacies, 7,500 GP practices and 7,600 dental practices, primary care providers are requested to start using these resources immediately.

The campaign materials, featuring real community pharmacy team members along with prominent green cross imaging, help explain to people that they can speak to the community pharmacy team about a range of minor health concerns.

In the first three weeks, campaign press coverage amounted to over 250 broadcast, press and radio pieces. Social media activity has so far provided 6.6 million opportunities for the target audience to see a post on Facebook, with 18,000 clicking the links included on the posts. Furthermore, 1.1 million have viewed at least 3 seconds of the TV advert video shared online and 230,000 have viewed the video in full.

Access the PHE Campaign Resource Centre, plus a whole library of support materials, via psnc.org.uk/ staywellpharmacy. Also, the Centre for Postgraduate Pharmacy Education (CPPE) highlights its materials in this month’s CPPE Corner on page 6.

NHS England is keen to build on these initial positive results and, with the addition of new materials to the Public Health England (PHE) Campaign Resource Centre, community pharmacy teams now have even more resources to make use of. The new materials are focused on the digital side of the campaign, and include a social media pack and banners for use on websites.

Update on price concession discussions Community pharmacy contractors may be aware that PSNC has been in discussions with the Department of Health and Social Care (DHSC) about changing the system for setting price concessions. DHSC is now trialling a new approach to price setting based on gathering timely data from manufacturers.

Learn more at: ow.ly/zlet30iPDoN

Prescription charge to rise to £8.80 The Government has announced an increase to the NHS prescription charge of 20 pence, to £8.80 per prescription item. This change will come into effect from 1st April 2018.

The cost of prescription pre-payment certificates (PPCs) has remained the same for a further year, with the price of a three-month PPC at £29.10 and a 12-month PPC at £104.

PPCs offer savings for those needing four or more items in three months or more than 12 items in one year.

Download the 2018 Prescription Charge Card PSNC has designed a downloadable Prescription Charge Card for community pharmacies.

The card will be available from the PSNC website very soon and has been designed to be easy to download and print ready for display in community pharmacies.

See: psnc.org.uk/chargecard As well as a printable colour PDF of the 2018 Prescription Charge Card, we will also provide a version optimised for printing in black-and-white.

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CONTRACT AND IT

DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

GDPR update for community pharmacies With the introduction of new data protection legislation on the horizon, PSNC outlines the support being made available to help contractors with compliance.

Community pharmacy contractors should be aware that the General Data Protection Regulation (GDPR) is approaching – all organisations must comply with the GDPR by 25th May 2018.

The GDPR and the UK data protection legislation that will accompany it represent an overhaul of data protection legislation and all organisations, including community pharmacy businesses, will need to take steps to ensure that they comply with it.

PSNC, with other stakeholders, is developing a guidance toolkit which will help community pharmacy contractors to comply with the regulation.

The guidance should be ready by the end of March and it will set out the steps that contractors need to take to comply with GDPR, as well as providing templates for contractors to use, and answering key FAQs. We are working on the guidance with the Community Pharmacy GDPR Working Group (which includes the National Pharmacy Association, the Company Chemists’ Association, the Association of Independent Multiple Pharmacies, the Centre for Pharmacy Postgraduate Education and the Royal Pharmaceutical Society) and are liaising with the Information Commissioner’s Office and NHS England.

Contractors are asked to sign up to PSNC’s emails to ensure that they are notified as soon as the guidance becomes available.

Sign up at: psnc.org.uk/email Background information on the GDPR is available on PSNC’s website (psnc.org.uk/GDPR) and detailed information is available from the websites for the Information Commissioner’s Office (ico.org.uk) and NHS Digital’s Information Governance Alliance (digital.nhs.uk/information-governance-alliance).

A summary of the changes for pharmacy • The need to demonstrate compliance with data protection principles and take other proactive steps for compliance including certain record keeping. For example, if you process personal data by consent (e.g. for direct marketing), the consent you have from data subjects must be GDPR compliant and you must have a record of that consent (before 25th May 2018 for existing data subjects).

• The need for a Fair Processing Notice to explain to data subjects how you process their data – what many are calling a Privacy Notice.

• The need to ensure you have appropriate agreements with those who process personal data for you or those whose personal data you process.

• The most problematic issue for community pharmacy is the Data Protection Officer (DPO). It may be that all pharmacy contractors will have to appoint a DPO, or, it may be that only those that process data concerning health on a ‘large-scale’ will have to appoint a DPO. (There is no clear definition of large-scale.) PSNC is working with other pharmacy and primary care organisations to try to limit the number of contractors who must appoint a DPO and, if this is unsuccessful, to ensure the guidance on DPOs is applied pragmatically to community pharmacy.

PSNC to hold GDPR compliance webinars As we approach the date that all organisations must comply with General Data Protection Regulation (GDPR), PSNC will be holding a webinar for community pharmacies.

During each webinar Gordon will explain what GDPR is, clarify what that means for the average pharmacy business, outline the steps contractors will need to take to comply, and talk you through the templates PSNC has developed as part of a cross-sector GDPR working group.

Community pharmacy contractors will have two opportunities to tune into a live webinar hosted by PSNC Director of Operations and Support, Gordon Hockey.

Gordon will also make sure you know where to find all the relevant resources created for contractors and where you can turn for additional support.

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Each webinar is expected to last around 60 minutes with some time devoted to answering your questions; so please tune in to make sure you understand what GDPR means for your pharmacy.

The two webinars are scheduled for Wednesday 4th April and Thursday 12th April, both at 7.30pm.

Please sign up at: psnc.org.uk/webinar

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HE HEALTHCARE LANDSCAPE

LPCs

PSNC’s WORK

FUNDING AND STATISTICS

Improving electronic information sharing from pharmacies New joined-up care project begins by looking at ways to better share data between community pharmacy teams and other healthcare professionals.

The Professional Records Standards Body (PRSB) has begun work on a new project to improve information sharing between pharmacy teams and the rest of the health and care sector, to improve patient care.

PRSB will work with NHS Digital, the Royal Pharmaceutical Society, PSNC and other pharmacy stakeholders to develop data standards so that information from community pharmacy services can be shared digitally with other services, with an initial focus on GPs. The information, which will include data on immunisations, medication and other patient related information, will support health and care professionals to make the right decisions about care.

Commenting on the start of this work, pharmacist and advisor to the project Stephen Goundrey-Smith, said: “Through new services and offerings, community pharmacists are becoming increasingly involved in patient care. From offering vaccinations to additional support and advice with medications, it is

more important than ever that we are sharing the right information with other care providers. A standard on pharmacy information flows will mean we are able to share the right information between services in a standardised way, ultimately leading to better quality care for patients.”

How can community pharmacists get involved in this work?

Community pharmacists that wish to work with PRSB (e.g. by attending workshops later this year) can contact PSNC’s Community Pharmacy IT Lead, Dan Ah-Thion, via da@psnc.org.uk Visit psnc.org.uk/CPDG to join the new Community Pharmacy Digital email group to hear about digital, IT and EPS developments and express your views on these topics. There will be updates about the PRSB and standards work.

Look out for further announcements about how pharmacy team members can get involved.

Time’s running out to complete key clinical governance actions In January’s CPN magazine, community pharmacy contractors were reminded about key clinical governance deadlines at the end of March and most will now have completed these actions.

For those who haven’t yet done so, PSNC strongly recommends making the completion of the Information Governance Toolkit, the Community Pharmacy Patient Questionnaire and a pharmacy chosen clinical audit a priority to meet the 31st March deadline.

(Note, NHS England has not specified a national audit for 2017/18, so only one pharmacy chosen audit needs to be undertaken.)

For more information, including a PSNC Briefing outlining the required actions, please visit: ow.ly/RXG030hJCaW

Highlight the work you do in #Pharmacy24 event An annual social media event celebrating the work pharmacy teams do on a daily basis will take place on Thursday 29th March.

During the 24-hour Twitter event, pharmacists, pharmacy technicians, and other pharmacy staff are invited to tweet their activities using the hashtag #pharmacy24. The event is specifically timed for the day before the Easter bank holiday weekend as this is one of the busiest times of the year for community pharmacy. #Pharmacy24 aims to make the contribution of pharmacy to patient care more visible and to celebrate the difference pharmacy makes, as well as demonstrating the scale and range of what pharmacy teams deliver in 24 hours. In the year the NHS turns 70, help celebrate the contribution of pharmacy in keeping the public safe. All those who work in the pharmacy sector are encouraged to join in by sharing anything that shows how much

of a positive difference you are making to your patients and the wider NHS. This year’s theme for #pharmacy24 is diversity: • The diversity of the pharmacy workforce; • The diversity of roles; • The diversity of the population we serve; • The diversity of careers; and • Shining a light on areas of diversity often overlooked or not sufficiently addressed – pharmacy has work to do and makes a contribution to addressing all of the above.

Whatever you can manage, this is the day to show everyone what you do every day.

psnc.org.uk 5

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

LPCs

Pharmacy anticoagulation service proves its value Research evaluation suggests a community pharmacy managed anticoagulation service can achieve clinical outcomes at a level consistently exceeding targets.

A research evaluation on a Community Pharmacy Anticoagulation Management service in Brighton and Hove has shown that community pharmacy is ideally positioned to provide good clinical outcomes whilst attaining high patient satisfaction for the level of service and skills of the pharmacy team involved.

Patients’ overall satisfaction for the service over the three years of data was very high, with feedback consistently rating above 98% at a minimum of ‘good’ whilst showing 67% rating the service as excellent.

The service was commissioned to transfer and maintain existing non-complex patients prescribed warfarin in secondary care within Brighton and Hove to clinics run on the pharmacy premises or via a domiciliary service.

It aimed to address some of the challenges faced by patients who require anticoagulant monitoring in secondary care – namely the accessibility of a centralised clinic supporting a wide geographical area – by bringing the service closer to the patient.

What did the service involve?

Patients were eligible for referral if they had at least two out of their last four readings in target range and did not fall into the exclusion criteria. Patients referred on to the service were non-complex and included either those requiring warfarin initiation or those who had already completed the initiation period and required ongoing monitoring.

At each clinic appointment a patient’s INR was measured by taking a capillary blood sample using a finger prick device and analysed using the same device. The

INR result was input into software which provided pharmacists with support on dosing and recall interval decisions. The system also provided an appointment book which could track patients and ensure follow up appointments are audited and actioned, as well as providing the pharmacists with detailed patient anticoagulation history and warfarin dosing algorithms.

Level of patient satisfaction with the service was measured by undertaking an annual patient survey.

Learn more about the service at: ow.ly/ CHbJ30ivieW

CPPE resources to support Stay Well Pharmacy campaign “

NHS England’s Stay Well campaign is running until 31st March 2018, aiming to increase the public’s confidence in community pharmacy, encouraging people to use their local pharmacy as the first port of call when dealing with minor health concerns.

Lesley Grimes

At the Centre for Pharmacy Postgraduate Education (CPPE), we have a variety of resources to ensure that you are equipped to help people deal with these concerns, not only during the winter months when coughs and colds are more significant issues, but with a range of minor ailments all year round.

CPPE lead pharmacist, learning development

Our learning programmes are designed to provide you with the clinical knowledge required to identify and manage common ailments, whilst always ensuring a focus on person-centred consultations.

We have distance learning resources to support the campaign, such as Common clinical conditions and minor ailments, as well as

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face-to-face learning including Advanced training in the assessment and management of urgent cases and Children and their medicines, enhancing your practice. You can test your knowledge on minor ailments with the Minor ailments: a clinical approach e-assessment.

For additional programmes related specifically to children, have a look at our Child health e-course and the Consulting with children and young people e-learning.

Our Safeguarding children and vulnerable adults e-learning can provide you with the skills, knowledge and confidence to deal professionally with any safeguarding issues that may arise in your practice.

Through continued learning and support, we can ensure that the Stay Well Pharmacy campaign makes an ongoing and increasing improvement to healthcare. Further information about any of the mentioned courses are available on the CPPE website (www.cppe.ac.uk), and a full list of collated resources to support the Stay Well campaign can be found on the PSNC website (psnc.org.uk/staywellpharmacy).

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PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

DISPENSING AND SUPPLY

Pharmacy notice board In this section of Community Pharmacy News we have highlighted some key notices for you and your team to be aware of in the coming weeks and months.

PHE launches nutrition campaign

on the Go’ campaign This month Public Health England (PHE) has launched the ‘Nutrition intake. calorie e excessiv people’s cut help to

tagline ‘400-600-600’ The campaign, part of the ‘One You’ initiative, has been given the adults should be calories of number the about g messagin clear to give simple but aiming to consume at breakfast, lunch and dinner. es from PHE’s Community pharmacy teams can access a range of free resourc 130iMq3N ow.ly/jf9 : campaign this support to centre e campaign resourc

New BLF resource to assist with MURs The British Lung foundation (BLF) has published a new consultation guide which aims to support pharmacists in undertaking a Medicines Use Review (MUR) on patients with asthma or COPD. The guide helps to ensure that pharmacists are asking the right questions and deliver clear messages to support better medicines understanding and healthy lifestyle messages.

It follows a format similar to the PSNC MUR worksheet and enables the minimum MUR dataset to be collected.

Download the guide from: ow.ly/g32N30 ivk2F

Fire risk of paraffinbased emollients

Community pharmacy teams may have seen recent news coverage of a BBC investigation which has highlighted the fire risk posed by paraffin-based skin emollients.

Pharmacy teams are therefore reminded that the Medicines and Health products Regulatory Agency (MHRA) issued a reminder in April 2016 about the need to appropriately advise patients who are being treated with paraffin-based skin products.

There is also an NHS poster available which may be useful to display in pharmacies. Find out more at: ow.ly/9 GPk30 inklv

Reminder: changes to the monthly NUMSAS claims process

claims that, in January 2018, the process for submitting Community pharmacy contractors are reminded d. change S) (NUMSA Service ed Advanc for the NHS Urgent Medicines Supply Contractors must now submit NUMSAS claims by: completing the existing NUMSAS claim form; (completed as part of the placing it along with the FP10DT EPS dispensing tokens and S’; ‘NUMSA marked clearly e NUMSAS) in an envelop monthly submission bundle. sending the envelope to the NHS BSA with the normal psnc.o rg.uk/n umsas For more information about NUMSAS, please visit:

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Changes to proof of exemption Certificates providing evidence of exemption from the NHS prescription charge will soon be changing as work towards digital certificates gets underway. measure, in a move towards using digital certificates in the future.

The NHS Business Services Authority (NHS BSA) is making changes to the types of proof of exemption. The white plastic cards currently in use for prescription prepayment certificates, maternity exemption certificates, medical exemption certificates and Tax Credit Exemption Certificates will soon be phased out as part of the NHS BSA’s service improvement programme. The plastic cards will begin to be replaced by a double-sided A4 paper certificate from March 2018 as an interim

From March 2018, Tax Credit Exemption Certificates will be the first exemption to be changed from plastic card to a double-sided A4 paper certificate. The paper certificate will contain very similar information to that currently held on the plastic cards. Other certificates currently using plastic cards will follow once NHS BSA has evaluated the success of the paper Tax Credit Exemption Certificates.

What types of exemption certificates might be presented in the pharmacy?

• Plastic exemption cards • Double-sided A4 paper certificates • Digital certificates

of exemption mentioned above should to be accepted as long as they are within their expiry date.

Community pharmacy teams should note it is the patient’s responsibility to make an accurate declaration. Checks are carried out on prescriptions claimed under exemption for fraudulent claims. Where patients do not have evidence or where there is doubt over whether the evidence provided is appropriate, mark the ‘Evidence Not Seen’ box on the reverse of the prescription.

Pharmacy staff need not refuse to dispense items on the basis that the patient does not provide evidence of their entitlement to free prescriptions.

NHS BSA envisages it taking up to five years for the plastic cards to be fully phased out so in the meantime the proof

The PSNC Dispensing and Supply Team has created a factsheet summarising the upcoming changes which can be found on page 9.

April 2018 pharmacy payment date Community pharmacy contractors are reminded that the next payment date for pharmacy accounts is 3rd April 2018. This is to meet the Department of Health and Social Care’s requirement for a maximum of 12 payments to be made in any one financial year.

Find out more at: ow.ly/9DR630iPFBI

Can it be dispensed on an FP10?

When pharmacy teams receive NHS prescriptions, they must check whether the items prescribed are allowed on the NHS before dispensing otherwise the pharmacy contractor may not be paid for them. Below is a list of some products that we have recently received queries about.

Product

Is the item listed in the Drug Tariff?

Is it Does it Can it be in the have a ‘CE’ dispensed blacklist?* mark? on an FP10?

Additional information

Vosene Original Shampoo

No

n/a

No

Yes

This item is not a medical device (CE marked) and is not listed in Part XVIIIA (the ‘blacklist’) of the Drug Tariff.

Aqua guard socks

No

n/a

Yes

No

This item is a medical device (CE marked) and is not listed in Part IX of the Drug Tariff.

Spycra Protect

Yes

n/a

Yes

Yes

This item is a medical device (CE marked) and is listed in Part IX of the Drug Tariff.

Blephasol Duo

No

n/a

No

Yes

This item is not a medical device (CE marked) and is not listed in Part XVIIIA (the ‘blacklist’) of the Drug Tariff.

*n/a is because medical devices are not listed in the blacklist.

Please note: If the prescription is an FP10CN or FP10PN (community nurse prescriber), an FP10D (dental prescriber) or an FP10MDA (instalment dispensing), please visit psnc.org.uk/prescriptionforms for more information.

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LPCs

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

All you need to know about: Changes to proof of exemption Our Dispensing and Supply Team explains how changes to certificates proving exemption from the prescription charge may affect community pharmacy teams.

The NHS Business Services Authority (NHS BSA) is making changes to the types of proof of exemption.

The white plastic cards currently in use for prescription prepayment certificates, maternity exemption certificates, medical exemption certificates and Tax Credit Exemption Certificates will soon be phased out. The plastic cards will begin to be replaced by a doublesided A4 paper certificate from March 2018 as an interim measure, in a move towards using digital certificates in the future.

From March 2018, Tax Credit Exemption Certificates will be the first exemption to be changed from plastic card to a double-sided A4 paper certificate. Other certificates currently using plastic cards will follow once NHS BSA has evaluated the success of the paper Tax Credit Exemption Certificates.

Separately, NHS BSA are currently trialling digital certificates for prescription prepayment certificates and maternity exemption certificates in the Northumberland area (see information on the digital maternity exemption service at: ow.ly/zfEp30iL65P).

Why are NHS BSA changing the types of proof of exemption?

Making this switch is part of the NHS BSA service improvement programme. Replacing the plastic cards will generate savings for the NHS and reduce the impact on the environment. White plastic cards will continue to be issued to certain patient groups (such as those without internet access).

Image courtesy of NHS Help with Health Costs

How long will it take phase out the current plastic exemption cards?

NHS BSA envisage it taking up to five years for the plastic cards to be fully phased out so in the meantime the proof of exemption mentioned above should to be accepted as long as they are within their expiry date.

What if the certificate is torn/damaged?

So long as the details are visible, and the number and expiry dates are clear then they can be accepted as proof of prescription exemption.

And finally, please remember: Community pharmacy teams are reminded it is the patient’s responsibility to make an accurate declaration. Terms of Service require that pharmacy teams, before supplying the drug or appliance, advise the person who has been asked to provide the evidence of entitlement to exemption that NHS checks are routinely undertaken to verify that persons are exempt from payment of NHS prescription charges as part of the relevant arrangements for preventing or detecting fraud or error.

Where patients do not have evidence or where there is doubt over whether the evidence provided is appropriate, mark the ‘Evidence Not Seen’ box on the reverse of the prescription. Pharmacy staff need not refuse to dispense items on the basis that the patient does not provide evidence of their entitlement to free prescriptions.

What types of exemption certificate might I see?

Certificate type

Guidance notes

Existing plastic Accepted as long as they are exemption cards within their expiry date.

Paper certificates

The double-sided A4 paper certificate will contain very similar information to that currently held on the plastic cards.

Digital certificates

Digital version of exemption certificate instead of a plastic card.

It could be on the screen of their smartphone or a printed copy, and it will include the patient’s name and an expiry date.

For more information on the changes to exemption certificates, please visit: www.nhsbsa.nhs.uk/changes-proof-exemption

PSNC resources: Exemptions from the prescription charge webpage psnc.org.uk/chargeexemptions Exemption status for EPS prescriptions psnc.org.uk/epsexemption Dispensing Factsheet: Checking Prescription Exemption Status psnc.org.uk/exemptionsfactsheet

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DISPENSING AND SUPPLY

SERVICES AND COMMISSIONING

THE HEALTHCARE LANDSCAPE

Ask PSNC The PSNC Dispensing and Supply Team can provide pharmacy teams with support and advice on a range of topics related to the Drug Tariff and reimbursement. Questions asked in recent months have included: Q. A person has presented a prescription and made a declaration that they are exempt from paying a prescription charge. I have asked them to produce satisfactory evidence of such entitlement, but they do not have it with them. Do I need to do anything else apart from ticking the “evidence not seen” box on the prescription?

Q. Does the Pricing Authority have lawful authority to deduct charges from a pharmacy’s reimbursement for a prescription where the reverse of the form has not been completed?

A. Yes. From 1st July 2016, the Terms of Service are amended to require pharmacy contractors, before supplying the drug or appliance, to advise the person who has been asked to provide the evidence of entitlement to exemption that NHS checks are routinely undertaken to verify that persons are exempt from payment of NHS prescription charges as part of the relevant arrangements for preventing or detecting fraud or error.

A. The National Health Service (Charges for Drugs and Appliances) Regulations 2000 as amended requires a pharmacy (and other NHS suppliers) to collect the prescription charge unless there is a valid claim for exemption (other than the exceptions, such as for oral contraceptives, or the age-related exemptions where the date of birth is printed on the form).

Please note pharmacy staff need not refuse to dispense items on the basis that the patient does not provide evidence of their entitlement to free prescriptions, it is the patient’s responsibility to make an accurate declaration.

Q. A patient has visited my pharmacy with an FP57 receipt for payment of prescription charges. The patient did not have their prepayment certificate to show but they had the prepayment certificate reference number and the date issued. They had bought their certificate from the Pricing Authority over the phone using their credit card but were waiting for the actual card to be sent to them. Can I issue a refund?

A. To issue a refund, it is necessary for you to see the actual prepayment certificate. The reference number and date issued is not definitive proof of exemption. FP57 forms are valid for three months and if the patient has recently applied for the certificate they should wait for the certificate to be received and then return to the pharmacy for a refund. The patient should receive the certificate well before the three months have expired.

Under Regulation 3(7) of those Regulations, “any sum payable by the local NHS England teams to the Chemist (i.e. reimbursement and remuneration to the pharmacy) shall be reduced by the amount of charges which are required to be made.” This requirement to deduct the amount equivalent to the charges for all chargeable prescriptions is mandatory, and therefore the Pricing Authority not only has lawful authority to deduct the charges but is required by the Regulations to do so.

To avoid switching pharmacy teams should ensure that the reverse of the prescription has been completed correctly.

For information on prescription switching see our page: psnc.org.uk/switching

Look out for more frequently asked questions next month…

If you would like more information on any of the topics covered, the team at PSNC will be happy to help (0203 1220 810 or e-mail info@psnc.org.uk).

Part XVI Notes on Charges The following changes have been made to the ‘List of contraceptive drugs to be dispensed free of charge’ as of 1st March 2018.

Added • Cilique 250microgram/35microgram tablets • Emerres Una 1.5mg tablets • Ezinelle 1.5mg tablets • Juliperla 75microgram/20microgram tablets • Leandra 30microgram/150microgram tablets • Sofiperla 75microgram/30microgram tablets • Yiznell 0.03mg/3mg tablets

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Removed • Bi Novum • Cleosensa • Femulen • Nacrez • Ovysmen • Trinovum

LPCs

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

Drug Tariff Watch A quick summary of the changes due to take place from 1st April 2018.

Part VIIIA additions • Anagrelide 500microgram capsules (100) – Category A • Adalimumab 40mg/0.4ml solution for injection pre-filled disposable devices (2) – Humira • Adalimumab 40mg/0.4ml solution for injection pre-filled syringes (2) – Humira • Adrenaline (base) 150micrograms/0.15ml (1 in 1,000) solution for injection pre-filled disposable devices SC (1) – Jext • Chloramphenicol 0.5% eye drops preservative free SC (10ml) – Eykappo • Colistimethate 1million unit powder for solution for injection vials (10) – Colomycin • Colistimethate 2million unit powder for solution for injection vials (10) – Colomycin • Degarelix 120mg powder and solvent for solution for injection vials (2) – Firmagon • Degarelix 80mg powder and solvent for solution for injection vials SC (1) – Firmagon • Eslicarbazepine 200mg tablets (60) and 800mg tablets (30) – Zebinix • Ibuprofen 200mg / Phenylephrine 6.1mg tablets (16) – Sudafed Sinus Pain Relief • Insulin aspart 100units/ml solution for injection 1.6ml cartridges (5) – NovoRapid PumpCart • Insulin degludec 100units/ml solution for injection 3ml cartridges (5) – Tresiba Penfill • Insulin degludec 100units/ml solution for injection 3ml pre-filled disposable devices (5) – Tresiba FlexTouch • Insulin degludec 200units/ml solution for

injection 3ml pre-filled disposable devices (3) – Tresiba FlexTouch • Insulin glargine 100units/ml solution for injection 10ml vials SC (1) – Lantus • Insulin glargine 300units/ml solution for injection 1.5ml pre-filled disposable devices (3) – Toujeo SoloStar • Linagliptin 2.5mg / Metformin 1g tablets (56) – Jentadueto • Linagliptin 2.5mg / Metformin 850mg tablets (56) – Jentadueto • Lorazepam 1mg/ml oral solution (150ml) – Thame Laboratories • Midazolam 10mg/1ml oromucosal solution pre-filled oral syringes sugar free SC (1) – Epistatus • Oxycodone 40mg / Naloxone 20mg MR tablets (56) – Targinact • Paliperidone 100mg/1ml suspension for injection pre-filled syringes SC (1) – Xeplion • Paliperidone 150mg/1.5ml suspension for injection pre-filled syringes SC (1) – Xeplion • Paliperidone 50mg/0.5ml suspension for injection pre-filled syringes SC (1) – Xeplion • Paliperidone 75mg/0.75ml suspension for injection pre-filled syringes SC (1) – Xeplion • Perampanel 2mg tablets (7) – Fycompa • Perampanel 2mg, 4mg, 6mg, 8mg, 10mg and 12mg tablets (packs of 28) – Fycompa • Risperidone 25mg powder and solvent for suspension for injection vials SC (1) – Risperdal Consta • Risperidone 37.5mg powder and solvent for suspension for injection vials SC (1) –

KEY: SC Special container R Item requiring reconstitution * This pack only (others already available)

Risperdal Consta • Risperidone 50mg powder and solvent for suspension for injection vials SC (1) – Risperdal Consta • Somatropin (epr) 5mg/1.5ml solution for injection cartridges SC (1) – Norditropin SimpleXx • Somatropin (epr) 10mg/1.5ml solution for injection cartridges SC (1) – Norditropin SimpleXx • Somatropin (epr) 15mg/1.5ml solution for injection cartridges SC (1) – Norditropin SimpleXx • Somatropin (rmc) 12mg/1.5ml solution for injection cartridges SC (1) – Saizen • Somatropin (rmc) 20mg/2.5ml solution for injection cartridges SC (1) – Saizen • Somatropin (rmc) 6mg/1.03ml solution for injection cartridges SC (1) – Saizen • Tacrolimus 3mg and 5mg MR capsules SC (50) – Advagraf • Typhoid polysaccharide 25micrograms/0.5ml vaccine solution for injection pre-filled syringes (1) and (10) – Typhim Vi Part VIIIA amendments • Carbocisteine 250mg/5ml oral solution (300ml) - Mucodyne Syrup is changing to Category A • Co-amoxiclav 875mg/125mg tablets (14) - Creo Pharma Ltd is changing to Brown & Burk UK Ltd

Part IX deletions Product

Type, Size and Product Code

TRACHEOSTOMY AND LARYNGECTOMY APPLIANCES: Silicone Adhesive (for use with baseplates) Replacement Foam Filters for ATSV II Replacement Foam Filters (normal resistance) Blom-Singer 16Fr

BE6067 BE1020 BE1070 IN4059

ANAL PLUGS - Renew Medical Inc - Renew Insert

Starter Pack (10) 702

TWO PIECE OSTOMY SYSTEM - ConvaTec Ltd - Closed Pouch with Filter (2-sided Comfort Backing)

Opaque - Standard (22.8cm) - all barrier sizes Opaque - Small (19.8cm) - all barrier sizes

TWO PIECE OSTOMY SYSTEM - ConvaTec Ltd - Closed Pouch with Filter (1-sided Comfort Backing)

Transparent - Standard (22.8cm) - all barrier sizes Transparent - Small (19.8cm) - all barrier sizes

TWO PIECE OSTOMY SYSTEM - ConvaTec Ltd - Closed Pouch without Filter (2-sided Comfort Backing)

Opaque - Small (19.8cm) for 13-48mm barrier (30) S1054N

TWO PIECE OSTOMY SYSTEM - ConvaTec Ltd - Closed Pouch without Filter (1-sided Comfort Backing)

Opaque - Mini (16.3cm) for 13-35mm barrier (20) S1060N

Mission Glucose Mission Ketone

1G (50) 1K (50)

psnc.org.uk 11

PSNC’s WORK

FUNDING AND STATISTICS

CONTRACT AND IT

PSNC resources library In this section of Community Pharmacy News we have provided details of some of the resources that PSNC has produced this month.

PSNC Briefings PSNC Briefing 008/18: Hosting a pharmacy visit for your local MP If you would like to organise a pharmacy visit for your local MP, this recently update PSNC Briefing provides guidance which can help in the planning and preparation of such a visit. Much of this advice is also applicable if you are arranging a visit for a local councillor.

Download from: ow.ly/2yCi30iQLJO PSNC Briefing 010/18: Dispensing & Supply Factsheet: Discount Deduction In this PSNC factsheet our Dispensing and Supply Team explains how discount deduction is applied to NHS prescriptions and which products are eligible to be included in the ‘Discount Not Deducted’ list.

Download from: ow.ly/8g8830iQLM1 PSNC Briefing 011/18: Refreshing NHS Plans for 2018/19 NHS England and NHS Improvement have issued a joint guidance document setting out the expectations for commissioners and providers in updating their operational plans for 2018/19. This PSNC Briefing summarises the elements of the document that are of most relevance to community pharmacy teams and LPCs.

Download from: ow.ly/GNIA30iQLGt PSNC Briefing 013/18: DHSC’s Working Group on reducing medication-related harm This PSNC Briefing summarises a recent report by the Department of Health and Social Care’s (DHSC) Working Group on reducing medication-related harm to highlight the most pertinent issues to community pharmacy.

Download from: ow.ly/aapD30iWg0k See all our PSNC Briefings in our database at: psnc.org.uk/briefings

Other resources Stay Well Pharmacy videos NHS England has begun a second wave of promotion for the Stay Well Pharmacy campaign, encouraging all community pharmacy teams to make use of new digital materials, including video clips.

Download the videos, and other resources, now: tinyurl.com/staywellpharmacy The General Data Protection Regulation(GDPR) GDPR represents an overhaul of data protection legislation. This webpage brings together information, guidance and resources to support community pharmacy contractors on making sure they comply by 25th May 2018.

Visit now: psnc.org.uk/GDPR Community Pharmacy Digital Group (CPDG) CPDG helps inform the Community Pharmacy IT Group on its to work supporting the development of pharmacy technology. Any pharmacy staff or LPC members with an interest in IT and digital developments can join the new Community Pharmacy Digital email group to hear about developments and express their views on these topics. This webpage outlines the group’s role.

Visit now: psnc.org.uk/CPDG Look out for additional resources as you explore our website: psnc.org.uk

PSNC website For up to date information and news on community pharmacy issues, visit the PSNC website at psnc.org.uk PSNC Community Pharmacy News is published by: The Pharmaceutical Services Negotiating Committee, 14 Hosier Lane, London, EC1A 9LQ Community Pharmacy News is edited by: Melinda Mabbutt who can be contacted at the above address or by email at: mmabbutt@psnc.org.uk PSNC Office: 0203 122 0810

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